Forms XI explained: this guide covers what it means, who it applies to, the step-by-step process, documents required, fees, due dates and penalties in India — so you can stay compliant with confidence and avoid costly mistakes.
Form XI is the notice of an accident or dangerous occurrence, sent to the Inspector-cum-Facilitator on the timelines in rule 7. Form XII is the notice of periods of work, displayed on the notice board and sent to the Inspector-cum-Facilitator under rule 71.
Form XI (rule 7(1) and (2)): after a death, notice forthwith; after an injury keeping the person from work for forty-eight hours or more, notice within twelve hours after the forty-eight hours are complete; dangerous occurrences within twelve hours (rule 7(3)). Form XII (rule 71): the notice under section 31(2) of the Code, displayed on a notice board or electronic board and sent to the Inspector-cum-Facilitator electronically or by speed post.
Where the forms come from
Rule 2(1)(b) of the Occupational Safety, Health and Working Conditions (Central) Rules, 2026 says "FORM" means the forms annexed in Annexure VII. Form XI implements rule 7, explained in our rule 7 article, and Form XII implements rule 71, explained in our rules 70-71 article. The Code link for Form XII is section 31, covered in our section 31 explainer.
The Central Rules apply where the Central Government is the appropriate Government. Where the State Government is the appropriate Government, the State's own OSH rules and forms apply. For help with accident reporting systems and records, see our labour law compliance service.
Form XI: when it is sent
Rule 7 (as printed) sets these occasions:
| Event | Who is told | Time |
|---|---|---|
| Accident resulting in death (rule 7(1)) | The Inspector-cum-Facilitator, in Form XI, forthwith. Also informed electronically and by telephone: Chief Inspector-cum-Facilitator(s), Inspector-cum-Facilitator(s), District Magistrate or Sub-divisional Officer, the officer in charge of the jurisdictional police station, and the family or kin of the victim | Forthwith |
| Accident with bodily injury preventing work for forty-eight hours or more immediately following (rule 7(2)) | Inspector-cum-Facilitator, electronically, in Form XI | Within twelve hours after the completion of forty-eight hours |
| Dangerous occurrence listed in rule 7(4), whether or not any injury (rule 7(3)) | Inspector-cum-Facilitator and the District Magistrate or Sub-divisional Officer | Within twelve hours |
| Death after the earlier notice (first proviso) | The authorities and persons in sub-rules (1) and (2), by telephone and electronically, confirmed in writing | Forthwith; written confirmation within twelve hours of the death |
| Disability of forty-eight hours not immediate but in more than one spell (second proviso) | Inspector-cum-Facilitator and District Magistrate or Sub-divisional Officer, in Form XI | Within twenty-four hours after the total disability reaches forty-eight hours |
The list of dangerous occurrences in rule 7(4) begins with the bursting of plant, pipeline or equipment containing petroleum, steam, compressed air or other substance at above atmospheric pressure; collapse or failure of a crane, derrick, winch, hoist or lifting appliance; explosion, fire, leakage or release of harmful toxic gases or escape of molten metal or hot liquid causing injury or damage; explosion of a pressure receiver or container; failure of lifting appliances in building or construction work; and, in belowground mines, spontaneous heating or outbreak of fire or smoke. The list is longer; read rule 7(4) itself for the full set.
A point to flag. Form XI is headed "See rule 7(1) and rule 7(2)", and rule 7(3), which deals with dangerous occurrences, does not name Form XI. The form's own title, "Notice of accident or dangerous occurrence", and its fields that speak of "accident or dangerous occurrence" throughout suggest it is also the vehicle for rule 7(3), but the text does not say so in terms. Use Form XI for dangerous occurrences, and confirm with the Inspector-cum-Facilitator's office if the portal offers another channel.
What Form XI asks
The form opens with the E.S.I.C. employer's code number and the E.S.I.C. insurance number of the injured person. The numbered items are:
- Name of employer.
- Address of works or premises where the accident or dangerous occurrence took place.
- Nature of industry and the LIN of the establishment.
- Branch or department and exact place.
- Name and address of the injured person.
- Gender; age at last birthday; occupation.
- Local E.S.I.C. office to which the injured person is attached.
- Date, shift and hour.
- Hour the injured person started work that day; whether wages in full or part are payable for the day of the accident.
- (a) Cause or nature; (b) if caused by machinery, the name of the machine and the part, and whether moved by mechanical power; (c) what the injured person was doing; (d) in the employer's opinion, whether the person was acting in contravention of any law applicable to them, of the employer's orders, or without instructions; (e) if yes to any of those, whether the act was done for the purpose of and in connection with the employer's trade or business.
- If while travelling in the employer's transport: whether travelling as a passenger to or from work, with the express or implied permission of the employer, whether the transport was operated by or on behalf of the employer or another person under arrangements with the employer, and whether the vehicle was or was not operated in the ordinary course of a public transport service.
- If while meeting an emergency: its nature and whether the injured person was employed for the purpose of the employer's trade or business in or about the premises.
- A brief description of how it took place.
- Names and addresses of witnesses.
- Nature and extent of injury (for example fatal, loss of finger, fracture) and its location.
- If not fatal, whether disabled for more than 48 hours, and the date and time of return to work.
- The physician, dispensary or hospital giving treatment, and the dispensary or panel doctor elected by the injured person.
- Whether the injured person has died, and the date of death.
It ends with a certificate that the particulars are correct in every respect to the signer's knowledge and belief, signed by the owner, employer, manager or agent, with the date of dispatch and place.
Items 10(d), 11 and 12 reflect questions of whether the accident arose in the course of employment, which matters for compensation. Answer them from facts, in writing, and avoid opinion beyond what 10(d) asks. The form's inclusion of E.S.I.C. numbers links to the insurance scheme, so the same data may be needed there.
Item 16 mentions "more than 48 hours", while rule 7(2) speaks of "forty eight hours or more". The rule's wording is the safer guide to when notice is due.
Form XII: notice of periods of work
Rule 71 says the notice under section 31(2) of the Occupational Safety, Health and Working Conditions Code, 2020 is displayed at conspicuous places on a notice board or electronic board of the establishment, maintained in Form XII, and a copy is sent to the Inspector-cum-Facilitator electronically or by speed post.
Form XII (See rule 71) has the heading "Notice of periods of work", with name of establishment, place and district, and a grid:
| Column group | Content |
|---|---|
| Periods of work | "On working days" with From and To entries; "On partial working days" with From and To entries |
| Men | Total number of men employed, by groups A to D, each with relays 1, 2 and 3 |
| Women | Total number of women employed, by groups E to H, each with relays 1, 2 and 3 |
| Description of groups, nature of work | Written description of each group and its nature of work |
| Remarks | Remarks |
At the foot: the date on which the notice is first exhibited, the employer's signature and date. The form's grid reads as a set of relays and groups, with a fixed layout. The text does not say how often it is revised; the Code and the rule are silent on timing, so update it whenever shift arrangements change and send the revised copy.
Practical examples
Example 1. A worker dies in a fall at a construction site. The employer informs the Inspector-cum-Facilitator forthwith with Form XI, tells the authorities and police by telephone and electronically, and informs the family.
Example 2. A press operator is injured on Monday at 10 am and cannot work for forty-eight hours. The forty-eight hours complete on Wednesday at 10 am, and Form XI goes electronically to the Inspector-cum-Facilitator within twelve hours after that.
Example 3. A factory runs two relays for men and one for women. It fills Form XII showing groups and relay hours, displays it on the notice board and sends a copy by speed post.
Compliance checklist
- Keep Form XI pre-filled with establishment details, and name who completes it.
- Keep a list of whom to telephone and email on a fatal accident.
- Time-stamp the injury and the end of the forty-eight hours.
- Display Form XII where workers can see it and send the copy on each change.
Need help with accident reporting?
Late or incomplete accident notices lead to enforcement questions. Our team can build an accident notification protocol, train the people who file Form XI, and review your Form XII. Start with our labour law compliance service.
Key takeaways
- Form XI is the notice of accident or dangerous occurrence; death requires notice forthwith.
- An injury keeping a person from work for forty-eight hours or more needs notice within twelve hours after the forty-eight hours are complete.
- Dangerous occurrences listed in rule 7(4) need intimation within twelve hours.
- Form XII is displayed and sent to the Inspector-cum-Facilitator electronically or by speed post.
- Rule 7(3) does not name Form XI, though the form covers dangerous occurrences.
Read next
- Rule 7: notice of accidents and dangerous occurrences
- Rules 70-71: double employment in mines and notice of periods of work
- Rules 75-76: register of accidents and register of leave with wages
- Forms XIII to XVI: employee, attendance, wage registers and wage slip
Disclaimer: Based on the Occupational Safety, Health and Working Conditions Code, 2020 (as enacted) and, where noted, the Occupational Safety, Health and Working Conditions (Central) Rules, 2026 (G.S.R. 345(E), 8 May 2026), as on 30 September 2026. The Code is in force from 21 November 2025; some provisions may be notified later, and State Governments make their own rules for establishments where the State is the appropriate Government. Verify the current position before acting.